Nuclear Oncology (Theranostics) = Therapy + Diagnostics

Nuclear Oncology is a new field of medicine which combines specific targeted therapy based upon a specific targeted diagnostic test.

With a key focus on patient centered care, nuclear medicine provides a transition from conventional medicine to contemporary personalized and precision medicine.

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Peptide Receptor Radionuclide Therapy (PRRT)

Nuclear Medicine uses Peptide Receptor Radionuclide Therapy (PRRT) which is targeted radiation to kill cancer cells from within.

The diagnostic component determines and defines the type and extent of the disease which allows decisions to be made on the timing, quantity, type of drugs, and choice of treatment options. The therapy component focuses on individualizing treatment by targeting therapy to an individual’s specific disease and administering the therapeutic agent to targeted sites of the disease which allows for higher doses administered safely to the site without significant exposure to normal tissue.

A treatment that uses targeted radiation to kill cancer cells from within. It is a form of nuclear medicine.
PRRT is comprised of a targeting molecule that binds to speciﬁc receptors (somatosta- tin) on the tumor cell surface and a radioactive particle that can kill the tumor cell.
LUTATHERA® (lutetium Lu 177 dotatate) is the ﬁrst FDA-approved PRRT.

Adults with gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that test positive for somatostatin receptors.

PRRT enables doctors to treat multiple GEP-NETs at the same time.
Studies have shown that PRRT may help slow down tumor growth.

PRRT is administered through an IV infusion.
A course of treatment typically includes 4 administrations, given 8 weeks apart.
Before and during each PRRT treatment, you will also be given amino acids to protect your kidneys from absorbing radiation, and medication to help with potential nausea and vomiting during treatment.
Each treatment will take several hours and you should be prepared to spend most of the day at the treatment center. You may want to invite a family member or friend to keep you company, unless the treatment center has any specific restrictions.

PRRT may be administered when surgery is not an option or when other treatments are not effectively slowing down tumor growth.
Your doctor will determine if PRRT (LUTATHERA) is appropriate for you by using a gallium 68 dotatate PET/CT scan to confirm that your tumors have the necessary receptors.
Before PRRT can be administered, it is necessary to test that you are eligible for treatment based on blood, kidney, and liver function.

How PRRT Works

The diagnostic component of theranostics determines and defines the type and extent of disease.

This information allows decisions to be made on timing, quantity, type of drugs, and choice of treatment options, as well as helping to evaluate a patient’s response to treatment.

The development of the companion therapeutic component focuses on individualizing treatment by targeting therapy to the individual’s specific disease. Because the therapeutic agent is specifically targeted to sites of disease (with significantly reduced drug exposure to normal tissue), higher doses of the therapeutic agent may be safely administered.

The theranostics care experience at Nebraska Cancer Specialists is the first of its kind in the Midwest.

Current Available Treatments

Pluvicto®

Pluvicto^TM (lutetium Lu 177 vipivotide tetraxetan) is indicated for the treatment of adult patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer (mCRPC) who have already been treated with other anticancer treatments (androgen receptor pathway inhibition (ARPI) and taxane-based chemotherapy)¹. It is a type of precision cancer treatment combining a targeting compound (ligand) with a therapeutic radioisotope (a radioactive particle)¹. After administration into the bloodstream, Pluvicto binds to target cells, including prostate cancer cells that express PSMA, a transmembrane protein¹. Once bound, energy emissions from the radioisotope damage the target cells and nearby cells disrupting their ability to replicate and/or triggering cell death¹.

Lutathera®

LUTATHERA® (lutetium Lu 177 dotatate) is a prescription medicine used to treat adults with a type of cancer known as gastroenteropancreatic neuroendocrine tumors (GEP-NETs) that are positive for the hormone receptor somatostatin, including GEP-NETs in the foregut, midgut, and hindgut.

Xofigo®

Xofigo® (radium Ra 223 dichloride) injection is used to treat prostate cancer that no longer responds to hormonal or surgical treatment that lowers testosterone. It is for men whose prostate cancer has spread to the bone with symptoms but not to other parts of the body.

I131 Radioactive Iodine (RAI)

I131 Radioactive iodine (RAI) is a therapy used in the treatment of some thyroid cancers, specifically papillary and follicular thyroid cancer.

Zevalin®

ZEVALIN® (ibritumomab tiuxetan) injection for intravenous use is a prescription medication that has three parts: two infusions of rituximab and one injection of Yttrium-90 (Y-90) ZEVALIN. Rituximab is used to reduce the number of B-cells in your blood and Y-90 ZEVALIN is given to treat your non-Hodgkin’s lymphoma (NHL).

The ZEVALIN therapeutic regimen is used to treat patients with:

Low-grade or follicular B-cell NHL that has relapsed during or after treatment with other anticancer drugs.
Newly diagnosed follicular NHL following a response to initial anticancer therapy.

Quadramet®

QUADRAMET® is an injectable radiopharmaceutical used to treat bone pain associated with certain kinds of cancer.

It is primarily used to treat the pain associated with osteoblastic and mixed bone metastases confirmed on a radionuclide bone scan and has demonstrated efficacy in patients with prostate, breast and other primary cancers.

Azedra®

AZEDRA® is a radiopharmaceutical used to treat adult and pediatric patients 12 years and older with cancers known as pheochromocytoma and paraganglioma that are positive for the norepinephrine transporter, and who require systemic anticancer therapy.

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Meet Our Nuclear Oncology Team

Our dedicated nuclear oncology team is here to streamline your care.

In addition to the benefits of targeted therapy over conventional chemotherapy, your care at Nebraska Cancer Specialists will truly be individualized to you and our dedicated nuclear oncology care team will be your strongest advocate. We strive to ensure you understand every stage of your treatment while making sure your care is efficient.